Research progress on prevention and management of postoperative enteral nutrition intolerance in patients with gastric cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YE Peiling ¹ , YUAN Xingzhu ¹ , LIU Changqing ² ,  LI Ka ¹

1. West China School of Nursing, Sichuan University / West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. Department of Anesthesiology, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

LI Ka, Email: lika127@126.com

Keywords：

gastric cancer; nutrition support; enteral nutrition; nutritional intolerance

DOI：

10.7507/1007-9424.202408080

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To summarize the existing prevention and treatment methods for postoperative enteral nutrition intolerance in patients with gastric cancer, so as to provide reference for clinical health care providers. Method The related literatures on the factors affecting and the prevention and treatment measures for postoperative enteral nutrition intolerance in Chinese and English databases were systematically searched, and summarized. Results The occurrence of enteral nutrition intolerance after gastric cancer surgery was the result of the interaction of multiple factors. Currently, the prevention and treatment measures of enteral nutrition intolerance covered various aspects, including traditional Chinese medicine therapies such as moxibustion and massage, optimizing the nutritional formula to improve tolerance, adjusting the enteral nutrition infusion methods to reduce adverse reactions, and strategies such as enteral nutrition preconditioning. However, the effectiveness of some measures still required further validation. Conclusions At present, a series of measures have been taken in clinic for enteral nutrition intolerance, and some results have been achieved. In the future, we should strengthen the identification of people at risk of enteral nutrition intolerance to prevent the occurrence of enteral nutrition intolerance. At the same time, a scientific enteral nutrition scheme is formulated to ensure the implementation effect of enteral nutrition and promote the prognosis of patients.

Citation： YE Peiling, YUAN Xingzhu, LIU Changqing, LI Ka. Research progress on prevention and management of postoperative enteral nutrition intolerance in patients with gastric cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(12): 1522-1527. doi: 10.7507/1007-9424.202408080 Copy

1.	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2.	郑荣寿, 陈茹, 韩冰峰, 等. 2022年中国恶性肿瘤流行情况分析. 中华肿瘤杂志, 2024, 46(3): 221-231.
3.	姚一菲, 孙可欣, 郑荣寿. 《2022全球癌症统计报告》解读: 中国与全球对比. 中国普外基础与临床杂志, 2024, 31(07): 769-780.
4.	李茁钰, 刘凯, 张维汉, 等. 全球及中国胃癌的流行病学特点及趋势: 2018–2022《全球癌症统计报告》解读. 中国普外基础与临床杂志, 2024, 31(10): 1236-1245.
5.	国家卫生健康委员会. 胃癌诊疗规范(2018年版). 中华消化病与影像杂志(电子版), 2019, 9(3): 118-144.
6.	杜雨家, 史业东, 孙小杰. 胃癌患者术后早期肠内营养不耐受的发生情况及其相关影响因素分析. 中华临床营养杂志, 2021, 29(6): 373-377.
7.	中国抗癌协会肿瘤营养专业委员会, 中华医学会肠外肠内营养学分会. 胃癌患者的营养治疗专家共识. 肿瘤代谢与营养电子杂志, 2023, 10(2): 208-212.
8.	Rinninella E, Cintoni M, Raoul P, et al. Effects of nutritional interventions on nutritional status in patients with gastric cancer: A systematic review and meta-analysis of randomized controlled trials. Clin Nutr ESPEN, 2020, 38: 28-42.
9.	Yan X, Zhou FX, Lan T, et al. Optimal postoperative nutrition support for patients with gastrointestinal malignancy: A systematic review and meta-analysis. Clin Nutr, 2017, 36(3): 710-721.
10.	Pimiento JM, Evans DC, Tyler R, et al. Value of nutrition support therapy in patients with gastrointestinal malignancies: a narrative review and health economic analysis of impact on clinical outcomes in the United States. J Gastrointest Oncol, 2021, 12(2): 864-873.
11.	Muscaritoli M, Arends J, Bachmann P, et al. ESPEN practical guideline: Clinical Nutrition in cancer. Clin Nutr, 2021, 40(5): 2898-2913.
12.	Reintam Blaser A, Starkopf L, Deane AM, et al. Comparison of different definitions of feeding intolerance: A retrospective observational study. Clin Nutr, 2015, 34(5): 956-961.
13.	Wu XY, Li XZ, Yu DL, et al. Construction of a model predicting the risk of tube feeding intolerance after gastrectomy for gastric cancer based on 225 cases from a single Chinese center. Oncotarget, 2017, 8(59): 99940-99949.
14.	周飞燕. 胃癌患者术后早期肠内营养喂养不足的调查分析及干预研究. 南京医科大学, 2012.
15.	Song J, Zhou C, Zhang T. Prognostic factors associated with gastrointestinal dysfunction after gastrointestinal tumor surgery: A meta-analysis. World J Gastrointest Surg, 2024, 16(5): 1420-1429.
16.	Zheng H, Zhang C, Wang Q, et al. The impact of aging on intestinal mucosal immune function and clinical applications. Front Immunol, 2022, 131029948. doi: 10.3389/fimmu.2022.1029948.
17.	Bhutto A, Morley JE. The clinical significance of gastrointestinal changes with aging. Curr Opin Clin Nutr Metab Care, 2008, 11(5): 651-660.
18.	Zhong Y, Cao Z, Baumer D, et al. Incidence and risk factors for postoperative gastrointestinal dysfunction occurrence after gastrointestinal procedures in US patients. Am J Surg, 2023, 226(5): 675-681.
19.	Reintam Blaser A, Jakob SM, Starkopf J. Gastrointestinal failure in the ICU. Curr Opin Crit Care, 2016, 22(2): 128-141.
20.	Jang A, Jeong O. Tolerability of early oral nutrition and factors predicting early oral nutrition failure after gastrectomy. Clin Nutr, 2020, 39(11): 3331-3336.
21.	Di Donna MC, Cucinella G, Giallombardo V, et al. Urinary, gastrointestinal, and sexual dysfunctions after chemotherapy, radiotherapy, radical surgery or multimodal treatment in women with locally advanced cervical cancer: a multicenter retrospective study. Cancers (Basel), 2023, 15(24): 5734. doi: 10.3390/cancers15245734.
22.	Cusack B, Buggy DJ. Anaesthesia, analgesia, and the surgical stress response. BJA Educ, 2020, 20(9): 321-328.
23.	Frøkjaer JB, Bergmann S, Brock C, et al. Modulation of vagal tone enhances gastroduodenal motility and reduces somatic pain sensitivity. Neurogastroenterol Motil, 2016, 28(4): 592-598.
24.	Reintam Blaser A, Deane AM, Preiser JC, et al. Enteral feeding intolerance: updates in definitions and pathophysiology. Nutr Clin Pract, 2021, 36(1): 40-49.
25.	何凤君. 术前口服营养补充对胃癌术后早期肠内营养耐受性及短期预后的影响. 四川大学, 2021.
26.	张东. 胃癌全胃切除术后2种消化道重建术式对肠道压力和生存质量的影响分析. 川北医学院, 2022.
27.	贾贵清, 王林, 侯能易, 等. 行Roux-en-Y吻合术的胃部疾病患者术后早期肠内营养不耐受的影响因素分析. 山东医药, 2018, 58(38): 57-59.
28.	Stavrou G, Kotzampassi K. Gut microbiome, surgical complications and probiotics. Ann Gastroenterol, 2017, 30(1): 45-53.
29.	Mazzotta E, Villalobos-Hernandez EC, Fiorda-Diaz J, et al. Postoperative ileus and postoperative gastrointestinal tract dysfunction: pathogenic mechanisms and novel treatment strategies beyond colorectal enhanced recovery after surgery protocols. Front Pharmacol, 2020, 11583422. doi: 10.3389/fphar.2020.583422.
30.	Liu X, Wang D, Zheng L, et al. Is early oral feeding after gastric cancer surgery feasible? A systematic review and meta-analysis of randomized controlled trials. PLoS One, 2014, 9(11): e112062. doi: 10.1371/journal.pone.0112062.
31.	Uray KS, Laine GA, Xue H, et al. Intestinal edema decreases intestinal contractile activity via decreased myosin light chain phosphorylation. Crit Care Med, 2006, 34(10): 2630-2637.
32.	Cox CS Jr, Radhakrishnan R, Villarrubia L, et al. Hypertonic saline modulation of intestinal tissue stress and fluid balance. Shock, 2008, 29(5): 598-602.
33.	Viscusi ER, Gan TJ, Leslie JB, et al. Peripherally acting mu-opioid receptor antagonists and postoperative ileus: mechanisms of action and clinical applicability. Anesth Analg, 2009, 108(6): 1811-1822.
34.	翁延宏, 顾国胜, 朱永龙, 等. 胃癌病人术后早期肠内营养不耐受的风险因素及对预后影响. 肠外与肠内营养, 2017, 24(3): 155-158, 163.
35.	Wang F, Hou MX, Wu XL, et al. Impact of enteral nutrition on postoperative immune function and nutritional status. Genet Mol Res, 2015, 14(2): 6065-6072.
36.	Li K, Xu Y, Hu Y, et al. Effect of enteral immunonutrition on immune, inflammatory markers and nutritional status in gastric cancer patients undergoing gastrectomy: A randomized double-blinded controlled trial. J Invest Surg, 2020, 33(10): 950-959.
37.	伍映鑫, 夏霖, 王勇, 等. 胃癌患者术前应用含ω-3不饱和脂肪酸的肠内营养制剂的临床效果观察. 中国普外基础与临床杂志, 2015, 22(3): 312-316.
38.	Seres DS, Ippolito PR. Pilot study evaluating the efficacy, tolerance and safety of a peptide-based enteral formula versus a high protein enteral formula in multiple ICU settings (medical, surgical, cardiothoracic). Clin Nutr, 2017, 36(3): 706-709.
39.	田俊梅, 赵永飞, 郅文娟. 短肽型肠内营养制剂对胃癌根治术后患者胃肠功能及营养状态的改善作用研究. 中国合理用药探索, 2020, 17(10): 35-38.
40.	钟海英, 黄凌莉, 周斌, 等. 胃大部切除术后早期整蛋白型和短肽型肠内营养的疗效观察. 药学与临床研究, 2018, 26(4): 291-294.
41.	汤亲青, 乐建军, 曹先东. 胃癌术后应用肠内营养制剂的对比研究. 肠外与肠内营养, 2021, 28(3): 147-151.
42.	Huang L, Li G, Zhou B, et al. Clinical effects of total protein and short peptide enteral nutrition during recovery after radical gastrectomy. Asia Pac J Clin Nutr, 2020, 29(2): 239-244.
43.	陈敏, 王颖, 施婕. 益生菌联合肠内营养对胃癌术后患者胃肠功能和营养状况影响的效果研究. 当代护士(下旬刊), 2021, 28(7): 16-19.
44.	O’Hara AM, Shanahan F. Gut microbiota: mining for therapeutic potential. Clin Gastroenterol Hepatol, 2007, 5(3): 274-284.
45.	陈永兵, 黄晓远. 益生菌对胃癌术后早期肠内营养不耐受的预防作用分析. 中外医疗, 2022, 41(16): 75-78.
46.	刘洋, 张利龙, 袁启航, 等. 益生菌联合肠内营养对比单用肠内营养在改善胃癌手术患者预后效果的Meta分析. 中国微生态学杂志, 2021, 33(5): 506-512.
47.	于健春. “序贯疗法”优化手术后早期肠内营养. 中华临床营养杂志, 2011, 19(3): 140-143.
48.	邢广巨. 胃癌患者术后康复治疗中采用序贯性早期肠内营养的价值研究. 反射疗法与康复医学, 2020, 1(21): 63-65.
49.	杨峰. 序贯性早期肠内营养对胃癌根治术后患者康复效果的影响探讨. 反射疗法与康复医学, 2022, 3(10): 140-142,146.
50.	王晓君. 胃癌术后序贯性早期肠内营养支持的临床效果及卫生经济学评价. 南京医科大学, 2014.
51.	Carmody RN, Gerber GK, Luevano JM, et al. Diet dominates host genotype in shaping the murine gut microbiota. Cell Host Microbe, 2015, 17(1): 72-84.
52.	Yamamoto T, Nakahigashi M, Saniabadi AR, et al. Impacts of long-term enteral nutrition on clinical and endoscopic disease activities and mucosal cytokines during remission in patients with Crohn's disease: a prospective study. Inflamm Bowel Dis, 2007, 13(12): 1493-1501.
53.	陈莉, 李如月, 白春花, 等. 肠内营养预适应对胃癌术后患者早期肠内营养相关并发症及胃肠功能的影响. 护理学杂志, 2018, 33(14): 83-86.
54.	He FJ, Wang MJ, Yang K, et al. Effects of preoperative oral nutritional supplements on improving postoperative early enteral feeding intolerance and short-term prognosis for gastric cancer: A prospective, single-center, single-blind, randomized controlled trial. Nutrients, 2022, 14(7): 1472. doi: 10.3390/nu14071472.
55.	中华医学会肠外肠内营养学分会. 中国成人患者肠外肠内营养临床应用指南(2023版). 中华医学杂志, 2023, 103(13): 946-974.
56.	陈尚传, 赵成功, 张明金, 等. 胃癌手术患者的肠内营养输注方案研究. 湖南师范大学学报(医学版), 2017, 14(3): 135-137.
57.	唐悦, 葛晓明, 孙晓光. 胃癌手术患者术后肠内营养输注方案研究. 中国现代普通外科进展, 2016, 19(12): 932-935,942.
58.	姜华, 赵军, 阚陈茹. 肠内营养不同输注方式在胃癌患者术后应用中的价值. 安徽医学, 2021, 42(9): 1064-1066.
59.	王翼飞, 王晓燕. 肠内营养泵在胃癌术后患者肠内营养中的应用. 现代医学, 2013, 41(2): 136-138.
60.	曹晓娜, 徐晓英, 金红芳. 不同方式早期肠内营养对胃癌患者术后机体恢复的影响. 中华临床医师杂志(电子版), 2014, 8(22): 4130-4133.
61.	杨友志. 用肠内营养泵对行胃大部分切除术的胃癌患者实施营养支持治疗的效果分析. 当代医药论丛, 2015, 13(24): 205-206.
62.	霍蕊, 张珍珍, 焦文芹, 等. 胃癌术后早期使用肠内营养泵的护理观察. 中华全科医学, 2011, 9(4): 646-647.
63.	郭小军, 张景琦, 张勇, 等. 中药汤剂在胃癌患者术后早期肠内营养中的应用. 现代肿瘤医学, 2008, 16(10): 1739-1741.
64.	王玉梅, 刘博, 周少英, 等. 十全大补汤辅助肠内营养支持治疗胃癌术后患者的临床研究. 现代中西医结合杂志, 2019, 28(21): 2309-2312,2327.
65.	王少言, 初巍巍. 四物汤对胃癌术后早期营养状态及免疫功能的影响. 解放军医药杂志, 2015, 27(6): 83-86.
66.	汪麟, 王彬翀, 李继杨. 中药辅助肠内营养干预对胃癌术后患者营养状况的影响. 中国食物与营养, 2019, 25(9): 87-89.
67.	郑州. 基于神经内分泌及胃肠激素机制探讨芪黄煎剂对胃肠动力的影响. 安徽中医药大学, 2020.
68.	蔡泽君. 八珍汤与早期肠内营养联合对胃癌术后患者营养状况影响的观察. 浙江中医药大学, 2017.
69.	李惠芬, 俞慧仙, 应学. 艾灸足三里干预胃癌术后行肠内营养引起腹胀的临床研究. 上海针灸杂志, 2016, 35(5): 543-544.
70.	谢薄, 吴莉莉. 热敏灸对胃癌病人根治术后早期肠内营养耐受性的影响. 肠外与肠内营养, 2019, 26(2): 83-86.
71.	吴艳红, 袁思成, 芮庆林. 不同施灸温度对胃癌术后早期肠内营养耐受性的影响. 上海针灸杂志, 2021, 40(7): 841-847.
72.	朱平, 王传思, 杨惠. 全息刮痧疗法对胃癌术后患者早期肠内营养耐受性的影响. 护理学杂志, 2022, 37(2): 35-37.
73.	杨海艳, 杨洋. 穴位按摩对胃癌术后患者早期肠内营养耐受性的影响. 世界最新医学信息文摘(连续型电子期刊), 2020, 20(52): 244-245,247.
74.	沈园园, 孙莹, 邱琳琳. 腹部按摩对胃癌术后患者早期肠内营养耐受性的影响研究. 吉林医学, 2017, 38(12): 2376-2377.

1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2. 郑荣寿, 陈茹, 韩冰峰, 等. 2022年中国恶性肿瘤流行情况分析. 中华肿瘤杂志, 2024, 46(3): 221-231.
3. 姚一菲, 孙可欣, 郑荣寿. 《2022全球癌症统计报告》解读: 中国与全球对比. 中国普外基础与临床杂志, 2024, 31(07): 769-780.
4. 李茁钰, 刘凯, 张维汉, 等. 全球及中国胃癌的流行病学特点及趋势: 2018–2022《全球癌症统计报告》解读. 中国普外基础与临床杂志, 2024, 31(10): 1236-1245.
5. 国家卫生健康委员会. 胃癌诊疗规范(2018年版). 中华消化病与影像杂志(电子版), 2019, 9(3): 118-144.
6. 杜雨家, 史业东, 孙小杰. 胃癌患者术后早期肠内营养不耐受的发生情况及其相关影响因素分析. 中华临床营养杂志, 2021, 29(6): 373-377.
7. 中国抗癌协会肿瘤营养专业委员会, 中华医学会肠外肠内营养学分会. 胃癌患者的营养治疗专家共识. 肿瘤代谢与营养电子杂志, 2023, 10(2): 208-212.
8. Rinninella E, Cintoni M, Raoul P, et al. Effects of nutritional interventions on nutritional status in patients with gastric cancer: A systematic review and meta-analysis of randomized controlled trials. Clin Nutr ESPEN, 2020, 38: 28-42.
9. Yan X, Zhou FX, Lan T, et al. Optimal postoperative nutrition support for patients with gastrointestinal malignancy: A systematic review and meta-analysis. Clin Nutr, 2017, 36(3): 710-721.
10. Pimiento JM, Evans DC, Tyler R, et al. Value of nutrition support therapy in patients with gastrointestinal malignancies: a narrative review and health economic analysis of impact on clinical outcomes in the United States. J Gastrointest Oncol, 2021, 12(2): 864-873.
11. Muscaritoli M, Arends J, Bachmann P, et al. ESPEN practical guideline: Clinical Nutrition in cancer. Clin Nutr, 2021, 40(5): 2898-2913.
12. Reintam Blaser A, Starkopf L, Deane AM, et al. Comparison of different definitions of feeding intolerance: A retrospective observational study. Clin Nutr, 2015, 34(5): 956-961.
13. Wu XY, Li XZ, Yu DL, et al. Construction of a model predicting the risk of tube feeding intolerance after gastrectomy for gastric cancer based on 225 cases from a single Chinese center. Oncotarget, 2017, 8(59): 99940-99949.
14. 周飞燕. 胃癌患者术后早期肠内营养喂养不足的调查分析及干预研究. 南京医科大学, 2012.
15. Song J, Zhou C, Zhang T. Prognostic factors associated with gastrointestinal dysfunction after gastrointestinal tumor surgery: A meta-analysis. World J Gastrointest Surg, 2024, 16(5): 1420-1429.
16. Zheng H, Zhang C, Wang Q, et al. The impact of aging on intestinal mucosal immune function and clinical applications. Front Immunol, 2022, 131029948. doi: 10.3389/fimmu.2022.1029948.
17. Bhutto A, Morley JE. The clinical significance of gastrointestinal changes with aging. Curr Opin Clin Nutr Metab Care, 2008, 11(5): 651-660.
18. Zhong Y, Cao Z, Baumer D, et al. Incidence and risk factors for postoperative gastrointestinal dysfunction occurrence after gastrointestinal procedures in US patients. Am J Surg, 2023, 226(5): 675-681.
19. Reintam Blaser A, Jakob SM, Starkopf J. Gastrointestinal failure in the ICU. Curr Opin Crit Care, 2016, 22(2): 128-141.
20. Jang A, Jeong O. Tolerability of early oral nutrition and factors predicting early oral nutrition failure after gastrectomy. Clin Nutr, 2020, 39(11): 3331-3336.
21. Di Donna MC, Cucinella G, Giallombardo V, et al. Urinary, gastrointestinal, and sexual dysfunctions after chemotherapy, radiotherapy, radical surgery or multimodal treatment in women with locally advanced cervical cancer: a multicenter retrospective study. Cancers (Basel), 2023, 15(24): 5734. doi: 10.3390/cancers15245734.
22. Cusack B, Buggy DJ. Anaesthesia, analgesia, and the surgical stress response. BJA Educ, 2020, 20(9): 321-328.
23. Frøkjaer JB, Bergmann S, Brock C, et al. Modulation of vagal tone enhances gastroduodenal motility and reduces somatic pain sensitivity. Neurogastroenterol Motil, 2016, 28(4): 592-598.
24. Reintam Blaser A, Deane AM, Preiser JC, et al. Enteral feeding intolerance: updates in definitions and pathophysiology. Nutr Clin Pract, 2021, 36(1): 40-49.
25. 何凤君. 术前口服营养补充对胃癌术后早期肠内营养耐受性及短期预后的影响. 四川大学, 2021.
26. 张东. 胃癌全胃切除术后2种消化道重建术式对肠道压力和生存质量的影响分析. 川北医学院, 2022.
27. 贾贵清, 王林, 侯能易, 等. 行Roux-en-Y吻合术的胃部疾病患者术后早期肠内营养不耐受的影响因素分析. 山东医药, 2018, 58(38): 57-59.
28. Stavrou G, Kotzampassi K. Gut microbiome, surgical complications and probiotics. Ann Gastroenterol, 2017, 30(1): 45-53.
29. Mazzotta E, Villalobos-Hernandez EC, Fiorda-Diaz J, et al. Postoperative ileus and postoperative gastrointestinal tract dysfunction: pathogenic mechanisms and novel treatment strategies beyond colorectal enhanced recovery after surgery protocols. Front Pharmacol, 2020, 11583422. doi: 10.3389/fphar.2020.583422.
30. Liu X, Wang D, Zheng L, et al. Is early oral feeding after gastric cancer surgery feasible? A systematic review and meta-analysis of randomized controlled trials. PLoS One, 2014, 9(11): e112062. doi: 10.1371/journal.pone.0112062.
31. Uray KS, Laine GA, Xue H, et al. Intestinal edema decreases intestinal contractile activity via decreased myosin light chain phosphorylation. Crit Care Med, 2006, 34(10): 2630-2637.
32. Cox CS Jr, Radhakrishnan R, Villarrubia L, et al. Hypertonic saline modulation of intestinal tissue stress and fluid balance. Shock, 2008, 29(5): 598-602.
33. Viscusi ER, Gan TJ, Leslie JB, et al. Peripherally acting mu-opioid receptor antagonists and postoperative ileus: mechanisms of action and clinical applicability. Anesth Analg, 2009, 108(6): 1811-1822.
34. 翁延宏, 顾国胜, 朱永龙, 等. 胃癌病人术后早期肠内营养不耐受的风险因素及对预后影响. 肠外与肠内营养, 2017, 24(3): 155-158, 163.
35. Wang F, Hou MX, Wu XL, et al. Impact of enteral nutrition on postoperative immune function and nutritional status. Genet Mol Res, 2015, 14(2): 6065-6072.
36. Li K, Xu Y, Hu Y, et al. Effect of enteral immunonutrition on immune, inflammatory markers and nutritional status in gastric cancer patients undergoing gastrectomy: A randomized double-blinded controlled trial. J Invest Surg, 2020, 33(10): 950-959.
37. 伍映鑫, 夏霖, 王勇, 等. 胃癌患者术前应用含ω-3不饱和脂肪酸的肠内营养制剂的临床效果观察. 中国普外基础与临床杂志, 2015, 22(3): 312-316.
38. Seres DS, Ippolito PR. Pilot study evaluating the efficacy, tolerance and safety of a peptide-based enteral formula versus a high protein enteral formula in multiple ICU settings (medical, surgical, cardiothoracic). Clin Nutr, 2017, 36(3): 706-709.
39. 田俊梅, 赵永飞, 郅文娟. 短肽型肠内营养制剂对胃癌根治术后患者胃肠功能及营养状态的改善作用研究. 中国合理用药探索, 2020, 17(10): 35-38.
40. 钟海英, 黄凌莉, 周斌, 等. 胃大部切除术后早期整蛋白型和短肽型肠内营养的疗效观察. 药学与临床研究, 2018, 26(4): 291-294.
41. 汤亲青, 乐建军, 曹先东. 胃癌术后应用肠内营养制剂的对比研究. 肠外与肠内营养, 2021, 28(3): 147-151.
42. Huang L, Li G, Zhou B, et al. Clinical effects of total protein and short peptide enteral nutrition during recovery after radical gastrectomy. Asia Pac J Clin Nutr, 2020, 29(2): 239-244.
43. 陈敏, 王颖, 施婕. 益生菌联合肠内营养对胃癌术后患者胃肠功能和营养状况影响的效果研究. 当代护士(下旬刊), 2021, 28(7): 16-19.
44. O’Hara AM, Shanahan F. Gut microbiota: mining for therapeutic potential. Clin Gastroenterol Hepatol, 2007, 5(3): 274-284.
45. 陈永兵, 黄晓远. 益生菌对胃癌术后早期肠内营养不耐受的预防作用分析. 中外医疗, 2022, 41(16): 75-78.
46. 刘洋, 张利龙, 袁启航, 等. 益生菌联合肠内营养对比单用肠内营养在改善胃癌手术患者预后效果的Meta分析. 中国微生态学杂志, 2021, 33(5): 506-512.
47. 于健春. “序贯疗法”优化手术后早期肠内营养. 中华临床营养杂志, 2011, 19(3): 140-143.
48. 邢广巨. 胃癌患者术后康复治疗中采用序贯性早期肠内营养的价值研究. 反射疗法与康复医学, 2020, 1(21): 63-65.
49. 杨峰. 序贯性早期肠内营养对胃癌根治术后患者康复效果的影响探讨. 反射疗法与康复医学, 2022, 3(10): 140-142,146.
50. 王晓君. 胃癌术后序贯性早期肠内营养支持的临床效果及卫生经济学评价. 南京医科大学, 2014.
51. Carmody RN, Gerber GK, Luevano JM, et al. Diet dominates host genotype in shaping the murine gut microbiota. Cell Host Microbe, 2015, 17(1): 72-84.
52. Yamamoto T, Nakahigashi M, Saniabadi AR, et al. Impacts of long-term enteral nutrition on clinical and endoscopic disease activities and mucosal cytokines during remission in patients with Crohn's disease: a prospective study. Inflamm Bowel Dis, 2007, 13(12): 1493-1501.
53. 陈莉, 李如月, 白春花, 等. 肠内营养预适应对胃癌术后患者早期肠内营养相关并发症及胃肠功能的影响. 护理学杂志, 2018, 33(14): 83-86.
54. He FJ, Wang MJ, Yang K, et al. Effects of preoperative oral nutritional supplements on improving postoperative early enteral feeding intolerance and short-term prognosis for gastric cancer: A prospective, single-center, single-blind, randomized controlled trial. Nutrients, 2022, 14(7): 1472. doi: 10.3390/nu14071472.
55. 中华医学会肠外肠内营养学分会. 中国成人患者肠外肠内营养临床应用指南(2023版). 中华医学杂志, 2023, 103(13): 946-974.
56. 陈尚传, 赵成功, 张明金, 等. 胃癌手术患者的肠内营养输注方案研究. 湖南师范大学学报(医学版), 2017, 14(3): 135-137.
57. 唐悦, 葛晓明, 孙晓光. 胃癌手术患者术后肠内营养输注方案研究. 中国现代普通外科进展, 2016, 19(12): 932-935,942.
58. 姜华, 赵军, 阚陈茹. 肠内营养不同输注方式在胃癌患者术后应用中的价值. 安徽医学, 2021, 42(9): 1064-1066.
59. 王翼飞, 王晓燕. 肠内营养泵在胃癌术后患者肠内营养中的应用. 现代医学, 2013, 41(2): 136-138.
60. 曹晓娜, 徐晓英, 金红芳. 不同方式早期肠内营养对胃癌患者术后机体恢复的影响. 中华临床医师杂志(电子版), 2014, 8(22): 4130-4133.
61. 杨友志. 用肠内营养泵对行胃大部分切除术的胃癌患者实施营养支持治疗的效果分析. 当代医药论丛, 2015, 13(24): 205-206.
62. 霍蕊, 张珍珍, 焦文芹, 等. 胃癌术后早期使用肠内营养泵的护理观察. 中华全科医学, 2011, 9(4): 646-647.
63. 郭小军, 张景琦, 张勇, 等. 中药汤剂在胃癌患者术后早期肠内营养中的应用. 现代肿瘤医学, 2008, 16(10): 1739-1741.
64. 王玉梅, 刘博, 周少英, 等. 十全大补汤辅助肠内营养支持治疗胃癌术后患者的临床研究. 现代中西医结合杂志, 2019, 28(21): 2309-2312,2327.
65. 王少言, 初巍巍. 四物汤对胃癌术后早期营养状态及免疫功能的影响. 解放军医药杂志, 2015, 27(6): 83-86.
66. 汪麟, 王彬翀, 李继杨. 中药辅助肠内营养干预对胃癌术后患者营养状况的影响. 中国食物与营养, 2019, 25(9): 87-89.
67. 郑州. 基于神经内分泌及胃肠激素机制探讨芪黄煎剂对胃肠动力的影响. 安徽中医药大学, 2020.
68. 蔡泽君. 八珍汤与早期肠内营养联合对胃癌术后患者营养状况影响的观察. 浙江中医药大学, 2017.
69. 李惠芬, 俞慧仙, 应学. 艾灸足三里干预胃癌术后行肠内营养引起腹胀的临床研究. 上海针灸杂志, 2016, 35(5): 543-544.
70. 谢薄, 吴莉莉. 热敏灸对胃癌病人根治术后早期肠内营养耐受性的影响. 肠外与肠内营养, 2019, 26(2): 83-86.
71. 吴艳红, 袁思成, 芮庆林. 不同施灸温度对胃癌术后早期肠内营养耐受性的影响. 上海针灸杂志, 2021, 40(7): 841-847.
72. 朱平, 王传思, 杨惠. 全息刮痧疗法对胃癌术后患者早期肠内营养耐受性的影响. 护理学杂志, 2022, 37(2): 35-37.
73. 杨海艳, 杨洋. 穴位按摩对胃癌术后患者早期肠内营养耐受性的影响. 世界最新医学信息文摘(连续型电子期刊), 2020, 20(52): 244-245,247.
74. 沈园园, 孙莹, 邱琳琳. 腹部按摩对胃癌术后患者早期肠内营养耐受性的影响研究. 吉林医学, 2017, 38(12): 2376-2377.

Previous Article
原发性乳腺血管肉瘤伴腋窝淋巴结转移1例
Next Article
Research progress in immunotherapy resistance of tumor-associated macrophages in gastric cancer

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Research progress on prevention and management of postoperative enteral nutrition intolerance in patients with gastric cancer

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content